Christopher Jones, MD

The outline below is meant for patients recovering from surgery for Rotator Cuff Repair. Details and steps can change depending on your situation.

PHASE I – 0-6 Weeks Post-Op

• No active ROM of the shoulder girdle
• Remain in sling
• **6 weeks is the crucial healing period**
• Scapular elevation, depression, protraction, retraction (e.g. “scapular clocks”)
• Pendulums with emphasis on “relaxed” shoulder and using the trunk as prime moving force
• Elbow, wrist, hand motion with the elbow at side
• Cryotherapy prn

PHASE II – 7-12 Weeks Post-Op

• Full ROM (Target to achieve full ROM by 12 weeks)
• Begin dry land active ROM without weight in biomechanically correct ROM only
• Discontinue sling

• Glenohumeral and Scapulothoracic joint mobilizations
• PROM (Target to achieve full ROM by 12 weeks)
• Minimal manual resistance for isometric ER and IR and rhythmic stabilization (flexion, extension, Horizontal ab/adduction) at 45°-90°-120° elevation in the scapular plane as patient gains control of the upper extremity
• AARON progressing to minimal manual resistance for PNF patterns
• Aquatic Therapy – Increase speed of movement for increased resistance as tolerated, progress to using hands as a “paddle” and then to webbed gloves for increased resistance as tolerated. Also add periscapular strengthening (i.e. wall push-ups, supine scapular retraction while floating)
• Begin dry land active ROM without weights. Must be in good biomechanical ROM. Add light resistance as the patient gains control of the movement with good biomechanics.
• Include these exercises:
  • Elevation in the scapular plane (initially supine, progress to inclined, then upright)
  • Prone Rowing
  • Serratus “punches” supine
  • Sidelying ER
  • Progress to IR on light pulleys or Theraband (after 6 weeks post-op only)
• As in Phase I, progress PROM as tolerated to full ROM
• All AROM exercises and isometrics. Again, emphasize proper biomechanics.

PHASE III – 13+ Weeks Post-Op

• Return to functional activities
• Begin a strengthening program
• G-H joint mobilizations and PROM when indicated
• Progress exercises in Phase II with increased weight based on 3 sets of 12-15 reps
• Gradually add the following exercises and progress weights:
  • Periscapular strengthening (wall push-ups, upright rowing, etc.)
  • ER, IR, and PNF patterns on pulleys
  • ER, IR, at 90° abduction
  • Begin functional progression for sports/activity-specific tasks
  • Begin isokinetic for ER, IR at 12 weeks post-op (Begin in modified abduction, progress to supine or sitting 90° abduction position)
• Maintain PROM
• Light Theraband exercise of ER, IR, Elevation, and “Full can” on non-PT days
• Progress to independent strengthening program prior to discharge